Many American states and municipalities have imposed measures to slow the spread of COVID-19 and “flatten the curve.”
They have closed “non-essential” businesses, schools, universities and public services. They have called for “social distancing” and prohibited meetings, sports events and other public gatherings.
Despite our best preventive health measures, however, thousands more people are expected to be hospitalized. And this will be expensive.
Pro publica and the Harvard Global Health Institute recently released a fascinating analysis of U.S. national, regional and municipal hospital capacity and COVID-19.
The report looks at hospital capacity under various scenarios. It asks what would happen to an area’s hospital capacity if 20% or 40% or 60% of the local population were infected with COVID-19 over a six-month, 12-month or eighteen-month period.
For example, Chicago would reach approximately 120% of total hospital capacity if 20% of the population were infected in six months, according to this model. But if 20% of Chicago’s population were infected over 18 months, hospital capacity would not be reached.
Many of those who have been infected with COVID-19 will be admitted to intensive care units with respiratory failure and will require support with mechanical ventilators.
A majority of American receive their health insurance through their jobs.
On April 2, the U.S. Department of Labor reported that more than 6 million people had filed for unemployment benefits. Many of these people have lost their health insurance; they have joined the ranks of the approximately 28 million Americans who had no health insurance prior to the COVID 19 crisis.
It has been estimated that the cost of a hospitalization for COVID 19 ranges from $38,000 to $74,000. And health care costs are a major cause of bankruptcy for many families.
So not only must a family worry about contracting COVID 19, they also may have to worry about being uninsured and if, God forbid, someone were to become ill, the stress of bankrupt could be a real possibility.
The Trump administration has stated that it will help hospitals by providing coverage for uninsured COVID 19 patients. But another way to approach and solve this problem would be to look at two very successful health programs — Medicare and Medicaid.
Both programs could be expanded to cover many of those uninsured Americans.
As the administration and Congress should consider lowering the age of Medicare eligibility to 60 years. This would help working people who are not old enough — age 65 — to be eligible for Medicare.
In a similar way, Medicaid eligibility could be relaxed. This can be done through an 1115 waive, which allows a state to request additional funding and flexibility in determining eligibility in providing care to those who qualify for Medicaid. Illinois Governor Jay Pritzker has applied for an 1115 waiver.
While the Trump administration’s plan to help uninsured COVID 19 patients is laudable, the plan does little for those uninsured patients who have other health issues requiring hospitalization.
We need to pressure the Congress and the Trump administration to address the long-term problem of the uninsured by expanding eligibility for Medicare and Medicaid. These steps will help us be prepared for healthcare in the post-COVID 19 era.
Dr. Alan Jackson is an assistant professor of Medicine at Rush University.
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